Caring for Children during Covid-19 | Parent and Caregiver Guide

Covid-19 has changed the way children play, learn, and live. Children may become clingy, withdrawn, angry, or start bedwetting. What can parents do to help them cope?

Respond to them supportively and listen to their concerns. Give them plenty of love and attention. Make extra time with them and remember to listen. Speak kindly and reassure them.  Make opportunities to relax and play. 

Keep children in touch with their teachers, friends, and extended family. If hospitalization occurs ensure contact by phone or video. Reassure them. 

Regular routines and schedules are required. Create new routines for learning, playing, relaxing and sleeping. Parents of younger children can implement a reward system to help kids stick with their new routine. Praise them whenever possible when they are doing the right thing. 

Provide facts about what has happened and explain what is going on. Give clear information about what to do to stay safe in words they can understand.

Provide information about what could happen in a reassuring way. Let them know they or a family member may start not feeling well. They may have to go to the hospital for some time so doctors can help them feel better. 

Parents must take care of themselves. It is OK to seek support from friends and adult family members away from their children so they can speak freely. Children will react to parental cues about how to respond, both emotionally and behaviourally. 

The red flags are the same. Suicidal ideation, self-harm behaviours, violent acting out, or a big change in normal functioning need urgent assessment. 

Stay safe, and reach out

References:

1. https://www.who.int/docs/default-source/coronaviruse/helping-children-cope-with-stress-print.pdf
2. https://www.medscape.com/viewarticle/928331

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Schizophrenia—Evolution of Humanness

Is schizophrenia bound to human evolution? Schizophrenia is a neuro-developmental disorder characterised by delusions, hallucinations, and bizarre behaviours. No other animal displays these symptoms. Depression, addiction, anxiety are all found in other animal species, but not schizophrenia. Schizophrenia is not even found in chimpanzees our most recent evolutionary ancestors. It is inheritable, and highly disadvantageous to survival of the affected person. Given this, schizophrenia should be almost non-existent. Yet it continues to affect a massive 1% of the global population. Something is pushing for the persistence of this disorder and its spontaneous manifestation in humans.

Human evolution separated from the chimpanzees 5.5 million years ago when we walked upright and then acquired language abilities. Language ability developed after 'lateralisation', the separation of brain functions into the left (sequential) and right (parallel processing) hemispheres. The peculiar delusions and hallucinations of schizophrenia can be understood as failure of the complex brain mechanism that enables the speaker to distinguish his thoughts from his speech or that of others. This brain mechanism evolved with lateralisation of brain functions. Loss of brain laterality in schizophrenia has been demonstrated.

Comparison of the gene sequences of early humans and their close evolutionary relatives, the Neanderthals have shown that regions of the human genome that underwent positive selection are enriched by association with schizophrenia. This suggests that schizophrenia susceptibility factors may be a "side effect" of human achievements like language and creative thinking. 

Recent evolutionary modifications in brain wiring and connections may have played a role in the development of schizophrenia in humans. Compared to our closest living relative the chimpanzee, brain connections present only in humans show a higher involvement in schizophrenia. Evolutionary changes in the human brain related to supporting more complex brain functions are paralleled with a higher risk for brain dysfunctions that can manifest as schizophrenia.

However, this genetic susceptibility is actually reducing. A study comparing modern-human-specific gene sites with archaic ones has shown that schizophrenia-risk related genes in modern humans are much less than those in Neanderthals and Denisovans (archaic humans). So negative selection of schizophrenia risk-related genes are probably being gradually removed from the modern human genome.

References

1. https://en.wikipedia.org/wiki/Human_evolution
2. Crow TJ. Is schizophrenia the price that Homo sapiens pays for language? Schizophr Res. 1997;28(2-3):127–141. doi:10.1016/s0920-9964(97)00110-2
3. Crow TJ. Schizophrenia as the price that homo sapiens pays for language: a resolution of the central paradox in the origin of the species. Brain Res Brain Res Rev. 2000;31(2-3):118–129. doi:10.1016/s0165-0173(99)00029-6
4. Srinivasan S, Bettella F, Mattingsdal M, et al. Genetic Markers of Human Evolution Are Enriched in Schizophrenia. Biol Psychiatry. 2016;80(4):284–292. doi:10.1016/j.biopsych.2015.10.009
5. van den Heuvel MP, Scholtens LH, de Lange SC, et al. Evolutionary modifications in human brain connectivity associated with schizophrenia. Brain. 2019;142(12):3991–4002. doi:10.1093/brain/awz330
6. Liu C, Everall I, Pantelis C, Bousman C. Interrogating the Evolutionary Paradox of Schizophrenia: A Novel Framework and Evidence Supporting Recent Negative Selection of Schizophrenia Risk Alleles. Front Genet. 2019;10:389. Published 2019 Apr 30. doi:10.3389/fgene.2019.00389